Purpose: To describe the efficiency and visual results of a new method of transconjunctival intrascleral fixation of single-piece foldable IOL using double-flanged 6/0 prolene suture. Materials and Methods: Seventeen aphakic eyes of 17 patients without adequate capsular support were involved in this study. Lens was prepared by passing the 6/0 prolene suture in a track in the haptic of single-piece foldable IOL created by 31 g needle. The 6/0 prolene suture was retrieved through a 30 g needle transconjunctivally to outside the globe; then, IOL was implanted and a terminal bulb was created at the outer end of the prolene suture. Results: All cases were aphakic after complicated phacoemulsification. In 10 cases hydrophilic IOLs were used and in 7 cases hydrophobic IOLs were used. There is clear statistically significant difference between pre-UCVA and post-UCVA. Complications included suture slippage in 2 cases and prolene bulb exposure in one case. There was no significant difference in endothelial cell count and IOP before and after 3 months. Conclusion: Transconjunctival intrascleral fixation of foldable single-piece IOLs is a safe efficient method for correcting aphakia.

BackgroundElevated oxidative stress plays a significant role in pathophysiology of keratoconus (KC). Polymorphisms of the antioxidant enzymes as CAT and GPX‐1 might alter their antioxidant enzyme capacities leading to increase in the oxidative damage induced KC.AimTo analyze the impact of CAT rs7943316 A/T and GPX‐1 rs1050450 C/T single nucleotide polymorphisms (SNPs) on the risk and severity of KC among a group of Egyptian population.Subject & methodsCAT rs7943316 and GPX‐1 rs1050450 SNPs were examined using polymerase chain reaction‐restriction fragment length polymorphism in 100 control subjects and 150 KC patients [50 patients (KC stages 1&2), 50 patients (KC stage 3) and 50 patients (KC stage 4)].ResultsPatients with TT genotype of CAT rs7943316 were at high risk of developing KC. T allele of GPX‐1 rs1050450 was significantly associated with KC risk (P ˂0.001). The frequency of CAT TT genotype and T allele was significantly higher among severe stages of KC compared to mild and moderate stages. GPX‐1 T allele frequency was significantly higher among severe stages of KC compared to mild and moderate stages. A very significant decrease in the antioxidant enzyme activities was observed in association with these SNPs. Age of the patients, CAT and GPX‐1 SNPs as well as their enzyme activities were independent predictors of KC severity.ConclusionOur study suggests that CAT (rs7943316) and GPX‐1 (rs1050450) SNPs act as independent predictors for different grades of KC and that these SNPs might have a role in the pathogenesis of the disease.

Purpose. To evaluate the safety and efficacy of a novel modified subscleral trabeculectomy technique in management of primary congenital glaucoma. Methods. This study included 25 infants diagnosed of having bilateral primary congenital glaucoma. For each patient, one eye was assigned to undergo subscleral trabeculectomy with trimming of the edges of the scleral bed (group I), while the contralateral eye underwent subscleral trabeculectomy with application of mitomycin C (0.4 mg/ml for 3 min) (group II). All the patients were followed up for a period of 14 ± 3 months (range 13–22 months). Results. 25 eyes were included in each group. Patients’ mean age was 2.5 ± 0.5 months (range 1.8–6.5 months). The mean preoperative intraocular pressure was 31 ± 4.9 mmHg and 32.1 ± 4.0 mmHg in group I and II, respectively. The mean postoperative intraocular pressure was 9.0 ± 1.0, 11.0 ± 3.2, 12.5 ± 0.9, 13.0 ± 2.9, and 15.5 ± 1.5 mm Hg in group I and was 10.3 ± 1.2, 12.0 ± 2.5, 13.5 ± 1.7, 15.0 ± 1.5, and 17.1 ± 2.8 mm Hg in group II at the first week and 1, 3, 6, and 12 months, respectively. There was no statistically significant difference between the mean intraocular pressure values recorded at both groups preoperatively and at each follow-up visit. Failure necessitating further surgical interventions was recorded in 4 eyes (16%) in group I as compared to 3 eyes (12%) in group II (P>0.05). Postoperative complications included mild hyphema, which occurred in one eye (4%) in group I and 2 eyes (8%) in group II, and shallow anterior chamber in 3 eyes (12%) in group I and in 2 eyes (8%) in group II. One eye (4%) in group I developed drawn-up pupil. Choroidal effusion developed in one eye (4%) at each group. Conclusion. Trimming the edges of the scleral bed adjacent to the sclera flap is a safe and effective surgical step which can be added to the subscleral trabeculectomy procedure to effectively control the intraocular pressure in patients with primary congenital glaucoma, sparing them the hazards associated with mitomycin C application.

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Background: Chronic dacryocystitis is the most frequent disorder in the lacrimal drainage system. The disease has been considered to be strongly associated with obstruction of the lacrimal duct, which creates a fertile environment for bacterial colonization and promotes lacrimal sac inflammation. Objective: The aim of this work was to evaluate lacrimal sac diameter in different age groups using ultrasound biomicroscopy (UBM). Patients and Methods: Twenty-four eyes of 24 normal individuals. They were divided according to age into 3 groups; group A: age ranging between 30 and 40 years, group B: age ranging between 40 and 50 years and group C: age above 50 years. Lacrimal sac diameter was assessed. Ocular examination and special tests were done for lacrimal drainage system (regurge test and fluorescein dye disappearance test) with imaging of lacrimal passages by ultrasound biomicroscopy. Results: All patients had no symptoms of epiphora, negative both regurge test and dye disappearance test and clear contents of the lacrimal sac. There was no statistically significant difference between groups regarding either longitudinal or horizontal lacrimal sac diameter. Conclusion: UBM can be used for imaging and measuring lacrimal passages and thus can be useful as an adjunctive to clinical examination and surgical planning in cases with lacrimal system diseases.